When President Joe Biden and former President Donald Trump square off in their inaugural general election debate this Thursday, health policy experts stress that addressing the soaring costs of health care stands out as a critical concern for voters, rivalling anxieties about the U.S. economy.

Health care expenditures in the United States persist on an upward trajectory, prompting more Americans to voice their inability to afford essential medical services.

Drew Altman, president and CEO of KFF, a nonprofit specializing in health policy research, underscored widespread voter frustration over exorbitant medical costs. "No health care issue comes close to matching voter frustration over the high costs patients face," Altman asserted. "While people tend to see health care and the economy as separate matters, voters view them as deeply intertwined. Health care expenses directly impact their economic well-being."

National health care spending is projected to have surged by 7.5% in 2023, approaching a staggering $4.8 trillion, outpacing overall economic growth, according to the Centers for Medicare and Medicaid Services.

Per capita health care spending, which signifies the average expenditure on health services per person, climbed to an estimated $14,423 in 2023 from $13,493 in 2022 and $13,012 in 2021.

These escalating costs are increasingly burdensome for Americans. A recent KFF poll revealed that nearly half of U.S. adults find it challenging to meet their health care expenses, with about a quarter reporting difficulties paying for health care over the past year. Dr. Adam Gaffney, a critical care physician at the Cambridge Health Alliance, highlighted how these financial strains often compel individuals to delay or forgo necessary medical treatments. "For American households, health care costs rank among the most critical economic concerns," Dr. Gaffney noted. "Health care spending represents a significant portion of many family budgets, especially those with children or elderly members managing chronic illnesses."

Despite Trump's renewed threats to dismantle the Affordable Care Act (ACA), commonly known as Obamacare, Altman suggested that significant health care reform is unlikely to dominate the debate. Biden, however, is expected to spotlight achievements under the Inflation Reduction Act, signed into law in 2022. Key provisions include empowering Medicare to directly negotiate drug prices with pharmaceutical companies, a landmark initiative that commenced with negotiations on Medicare's ten costliest prescription drugs earlier this year.

Trump's health care policy agenda for a potential second term remains scant beyond his emphasis on reducing prescription drug costs, including proposals to permit drug imports from Canada and linking drug prices to international benchmarks.

Robin Feldman, a professor of law and director of the Center for Innovation at UC Law San Francisco, emphasized the challenge both Biden and Trump face in garnering bipartisan support for their health care cost policies. "The current political climate in Congress reflects a marked absence of unity and compromise, mirroring divisions across the nation," Feldman observed.

Dr. Gaffney underscored the difficulty of achieving sweeping health care reforms in such a polarized environment. "The prospect of major, comprehensive health care reform in recent years has seemed increasingly remote," he remarked.

Altman lamented the artificial separation between health care and the economy in political discourse. "This divide between health care as a separate issue and the economy as another is frustrating because, for real people, there's no separation. It's one of their most urgent economic concerns," he emphasized.

As the debate unfolds, the candidates' approaches to addressing health care costs will profoundly resonate with voters, influencing their decisions in the upcoming election.